Feeding tubes can be placed for a variety of reasons, such as difficulty swallowing due to esophageal or neurologic diseases or after a stroke, during treatment for head & neck cancer, after some abdominal operations, or simply for nutritional support in patients not eating enough.
Three major types of feeding tubes can be placed:
Feeding tubes can usually be placed with endoscopy or radiology guidance, though may need to be placed via laparoscopic or open abdominal operations, or placed at the time of other laparoscopic or open abdominal surgery.
Preoperative Information
Prior to feeding tube placement, you will be asked not to eat or drink anything after
midnight prior to your surgery. You will be given specific instructions from your
surgeon or anesthesiologist about which medications you should or should not take
prior to your surgery. You should not take any blood thinning medications at least
5 days prior to your operation. This should be discussed with your surgeon at your
preop visit.
You will also have an appointment with a Nutritionist who will go over care of your feeding tube and provide information on the feeding formula you will need.
Postoperative Information
Your recovery will vary depending on the type of feeding tube you had placed and the
method used for placement.
Activity
You can resume most usual activities gradually beginning shortly after surgery. You
should begin walking the night of surgery or the following morning and continue to
increase as you are able. Increase activity to reduce the risk of blood clots and
improve breathing to prevent pneumonia.
Avoid driving until you no longer need narcotic pain medication. Driving while taking them can impair your ability to drive safely.
You should be able to return to work within 1 week after surgery.
Wound Care
All feeding tubes involve a catheter that protrudes from the abdomen. Depending on
the size and type of tube, you may need to secure the tube with tape, a bandage wrap,
or abdominal binder.
Because these tubes connect directly to the stomach or intestine, it is common to have a small amount of leakage around the tube. A single layer of gauze under or around the tube will prevent this from irritating your skin and leaking onto your clothing. Over time, if the tube hangs in the same position too long, the hole may enlarge and result in increased leakage and skin irritation. If this occurs, the tube should be bolstered on either side with a rolled gauze or washcloth to keep the tube perpendicular (straight out) to the abdominal wall. The hole will close back to the size of the tube within a couple of days.
If your feeding tube was placed laparoscopically or open, you will have other incisions besides the feeding tube site. A small gauze and clear tape dressing or a small white dressing is typically placed over each incision. These dressings can be removed 48 hrs (2 days) after the operation. Below this dressing are small brown or white pieces of tape (called Steri-Strips); these will fall off on their own within 1-2 weeks or be removed at your follow-up visit with your surgeon. If you have staples, they will be removed at your follow-up visit, usually in 10-14 days. If your surgeon gives you specific instructions other than this, please follow those instructions.
You may shower after 48hrs (after the gauze and clear tape dressing is removed). It is okay to get soap and water on the incisions. Pat the area dry. It is not recommend that you submerge underwater (in a bathtub, pool, or hot-tub) for at least 2-3 weeks post-op.
You will be given detailed instructions on the care of your feeding tube from the Nutritionist and nursing staff. Basically, the skin around the tube should be kept clean and dry. The tube should be flushed regularly with water. Feeds should be given according to your Nutritionist's instructions. For full details about caring for your feeding tube, click here.
If you notice redness around your incisions, especially if it is getting worse or associated with drainage or a fever, you should contact your surgeon.
Medications - Pain Management
Pain is typically just around the site of incisions, but after laparoscopic surgery,
you may have more general abdominal pain or even shoulder pain due to the air used
to inflate your abdomen during the surgery. Pain from air inflation will go away in
24 to 48 hours.
You will likely be discharged with pain medication, typically a mild to moderate strength narcotic, depending on the type of feeding tube you had placed. Take as needed and as prescribed. You may also take over-the-counter medications such as ibuprofen for pain. Most narcotic medications prescribed are combined with Tylenol (acetaminophen) and you should not take additional Tylenol if you are taking a narcotic medication that already contains Tylenol.
Other Medications
You may be prescribed a stool softener when you go home. Pain medications can cause
constipation and a stool softener may help. You may also be given nausea medication
if you have experience nausea or vomiting from taking your pain medication.
It is common to have some constipation after surgery, especially when taking narcotic pain medications. You will probably be prescribed a stool softener when you are discharged. If you are having trouble moving your bowels after surgery (if your stool is hard or you have to strain excessively) you may need a laxative. Over the counter medications can treat this well. Senna, Miralax, or dulcolax are some of the most common and are available at most drug stores or grocery stores. Take as directed.
If you are having trouble having a bowel movement AND have abdominal bloating, nausea or vomiting, and not passing gas, you should call your doctor.
Home Medications
Unless otherwise instructed, you should be able to resume your usual home medications
the night of or the morning following your surgery. Some medications can be safely
taken through feeding tubes by crushing them or changing to a liquid form. However,
some cannot and may have no effect or worsened side effects if given this way. Check
with your doctors about which medications can be given through your tube.
Diet
Depending on why your feeding tube was placed, you may resume your usual diet as you
feel able OR begin tube feeds as instructed the morning following your surgery. You
may have some abdominal bloating or mild nausea after your operation, so eat slowly
and only what you can tolerate. Your appetite may be less than usual but typically
returns to normal within a week or two. Be sure to drink plenty of liquids (6-8 glasses
of water or juice each day) if your appetite is not very good.
If you are totally dependent on the feeding tube, please ensure you are flushing with enough water to prevent dehydration. Your nutritionist will give detailed instructions on how much formula to take, how and when, as well as how much extra water should be given or added to the formula.
Follow Up
You will be given a date and time to see your surgeon following surgery, usually in
10 days to 3 weeks. If you are discharged late in the day or over the weekend, you
will be given a number to call the following business day for an appointment. If you
are having trouble making an appointment, you should call your doctors' office directly
for assistance.
Call Your Doctor If:
Contact Information
Daytime hours: Call 706-21-4686 or 7597
After hours and weekends: Call 706-21-8400